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Policy & Code of Conduct Acknowledgement
Please read the Policy for the Protection of Children and Young People along with the Code of Conduct for the Diocese of Salina.
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1
Name
*
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First Name
Last Name
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2
Email
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example@example.com
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3
Role or Ministry in which you serve
*
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Select all that apply
Employee
Catechist (PK, K-6, JrYM, SrYM)
Nursery
Children's Liturgy
Thom's Moms
Volunteer
Small Group Leader (e.g. Little Flowers, Endow, etc.)
Other
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4
Are you a Youth or Adult?
*
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Adult
Youth Gr 6-8
Youth Gr 9-12
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5
Policy & Code of Conduct Acknowledgement
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6
Policy & Code of Conduct Acknowledgement for Minors in Grades 6-8
*
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7
Policy & Code of Conduct Acknowledgement for Minors in Grades 9-12
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8
Signature of Student Volunteer
*
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Clear
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9
Signature of Parent/Guardian
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Clear
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10
Date
-
Date
Year
Month
Day
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